Provider Demographics
NPI:1376819599
Name:FAMILY CARE COUNSELING
Entity Type:Organization
Organization Name:FAMILY CARE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:GREENHALGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:386-427-2241
Mailing Address - Street 1:211 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7115
Mailing Address - Country:US
Mailing Address - Phone:386-427-2241
Mailing Address - Fax:386-427-2242
Practice Address - Street 1:211 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7115
Practice Address - Country:US
Practice Address - Phone:386-427-2241
Practice Address - Fax:386-427-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0951106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty